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A public hospital is not just another business

OTHER VOICES

Ocala, FL - September 11, 2011

Published in Ocala Star-Banner on Sunday, September 11, 2011 at 6:30 a.m.

"Home is the place where, when you have to go there, They have to take you in."

Robert Frost, "The Death of the Hired Man"

Munroe Regional Medical Center, being a public hospital, is like a home.

When I read letters from taxpayers worried about taxes and being critical of Munroe's administration, these are the thoughts that come to my mind:

During my 30 years as a resident of Ocala and a practicing physician, even when Munroe was financially successful, people were critical of the hospital and the administration.

Certain individuals at that time wanted to sell the hospital to a private corporation and collect a commission for the sale. Today, the same mentality exists.

Before anyone voices an opinion that is not constructive and helpful, think what might happen if MRMC did not exist or was owned by a private corporation. With the present situation, any patient who walks into MRMC cannot be turned away without being provided care or being referred for treatment. If he or she is uninsured or is unable to pay, MRMC is still responsible for their care.

In Munroe's absence, who would deliver babies or provide children's care? As residents of this county, we have to pay for this care in taxes or as a paying patient or as a physician who is providing free care. But now, with the present reality, physicians are having difficulty providing free care because of the low profit margin. This applies to the hospitals, also.

Any business, including mine and yours, could be managed better. Managing a hospital is unique, different and extremely difficult for the following reasons:

  1. A hospital has too many "bosses," i.e., patients, taxpayers, county commissioners, insurance companies and doctors.
  2. The person (patient) who buys the service is not the one who pays for it. A second party (insurance company) pays for it.
  3. They do not pay what you charge, but what they decide to pay.
  4. You don't get paid at the time of service; you get paid a few months later. You do not get to discuss the charges before the service is provided but after the service is provided. This is the only type of service where you provide the service and then try to collect for it later. You cannot discuss the service provided or charge interest.
  5. When you provide free care, you have to spend money to buy medicines and other supplies used for the patient's care. The suppliers expect to be paid prior to making these items available.
  6. The cost of providing care is determined by the suppliers, doctors, drug companies and the patients, who can demand a level of care such as special scans and/or treatment.
  7. You still can be sued for refusing care, accidental error or a poor outcome.

Managing or selling your private business for profit does not make you an expert in managing a hospital. You also are not an expert if you cannot explain why a hospital needs to charge $5 for a Tylenol instead of 50 cents.

Even the best-run public hospitals in this country are losing money and need taxpayer support to stay afloat. Hospitals like Jackson Memorial in Miami are shutting down elective dialysis in order to save money. Now, patients go to the emergency room to get dialysis at twice the cost.

If you want to help and pay less in taxes, please be constructive in your criticism. Stop ruining the hospital's reputation, and be supportive.

When a country is involved in a costly war and spending a great deal of money, and at the same time, it is cutting taxes, the hospitals also would go broke. We do not want to do the same with Munroe Regional Medical Center.

Rangaswamy Asokan, M.D., is an Ocala plastic surgeon who has practiced in our community for 30 years.

http://www.ocala.com/article/20110911/OPINION/110909660/1162/sitemaps?p=3&tc=pg


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